Cases Of Sickness Research Articles

Chronic Mountain Sickness-Phobrang Type

Clinical0 features of 27 cases of Chronic Mountain Sickness (CMS) from the Himalayas are reported. They are compared with 75 native highlanders (NH). All CMS patients were immigrants to high altitude. Mean duration of stay at high altitude was seven years. Mean values for haematocrit and haemoglobin were 80% and 23 G% respectively for the CMS group and 40% and 17.9 G% respectively for the native highlande group. Mean QRS axis in the former was +118 and in the latter +76. Incidence and quantum of protienuria were significantly higher in the CMS group. Cardiac catheteri -sation studies done in eight CMS cases showed elevated Pulmonary Artery (PA) pressures even after a mean of 14.2 days at sea level. The disease which has four diagnostic elements-hypoxemia and polycythemia, pulmonary hypertension, right ventricular enlargement and nephropathy with dense proteinuria-is a variant of 'Monge's Disease' and a name CMS Phobrang Type is suggested, along with a new approach to clinical classification which may help in diagnosis before cor pulmonale sets in. Limited therapeutic trials conducted at highaltitude seem to indicate that yogic deep breathing exercises, low-dose aspirin and diamox may be beneficial in the prevention and therapy of CMS Phobrang Type at high altitude.

Western and Indian models of turnaround management

The author compares Western and Indian mechanisms for turning around sick corporations. Based on 18 Western case studies, the paper links cases of sickness with turnaround mechanisms. The author also presents a model for preventing sickness in organizations.

Delayed Treatment of Dysbarism

Fifty cases of decompression sickness are reviewed in which recompression treatment was delayed for 12 hours or longer after the onset of dysbaric symptoms. Twenty-four patients (48%) had pain only. The other 26 patients (52%) had more serious decompression sickness; two patients may have had air embolisms. Ninety percent of the patients recovered either completely (66%) or substantially (24%) with recompression and associated treatment, although standard recompression protocols had to be lengthened in many of the cases.

Corticosteroids in treatment of serious decompression sickness

Although high-dose corticosteroids have been widely recommended as an adjunctive measure in the treatment of serious decompression sickness, there are few objective data to support their efficacy in this disease. An unusual case of neurological decompression sickness which seemed to demonstrate a therapeutic response to steroids independent of recompression is presented. The various manifestations of decompression sickness and the effectiveness of delayed treatment are discussed.

The dental management of a partially edentulous patient suffering from hepatolenticular degeneration (Wilson's disease).

Abstract— A case of Wilson's sickness and its sequelae is described. A treatment procedure is suggested using a combination of skeleton designed cobalt chromium dentures and roach ball precision attachments and its advantages for the patient outlined.

ACUTE DECOMPRESSION SICKNESS

A case of acute decompression sickness presenting severe clinical features was reported. At the time of autopsy, intra‐and extravascular air bubbles were found in various organs. Pulmonary fat embolism was also prominent in association with severe circulatory disturbances of the lungs. The spinal cord showed edematous and congestive swelling which was intimately related to the coagulation of blood within the epidural veins that contained innumerable fat droplets. Intravascular fat seemed to be created in and released from the injured adipose tissue, especially that of the bone marrow during decompression and to have acted as an accelerator of intravascular coagulation. The pathophysiological significance of the fat embolism for the development and the progression of decompression sickness is discussed.

Ventricular dysrhythmia associated with serious decompression sickness

A case of serious decompression sickness complicated by frequent, unifocal, premature ventricular contractions (PVC) is presented. Although no cardiac monitoring was available, a continuous lidocaine infusion was used during recompression treatment to treat the PVCs, and it appeared to produce no untoward side effects. The concerns about using lidocaine in the dysbaric patient subjected to a hyperbaric oxygen environment are discussed.

Nature and treatment of decompression sickness occurring after deep excursion dives : Greene, K. M. and C. J. Lambertsen, 1980. Undersea biomed. Res., 7(2): 127–139

During Predictive Studies IV (PS IV), the fourth in a series of collaborative undersea investigations, plans were made for excursion compressions to 1200 and 1600 feet of sea water (fsw) from saturation depths of 800 and 1200 fsw, respectively. Three cases of decompression sickness (DCS) occurred in the excursion phases of PS IV; all were relieved by prompt treatment, and there were no residual effects. This paper describes the rationale and treatment regimen used for deep excursion DCS, reports the results of the treatment, and makes specific recommendations of the therapy of DCS occurring after such excursions.

Synthetic fibers are heading for prosperity

Synthetic fibers were the leading sick case for the U.S. chemical industry so long that the illness began to look chronic, even terminal, to some industry analysts. It may be a surprise, therefore, that the patient is mending fast and may be due for several years of excellent health. The rapid recovery in fibers is a good omen for the entire U.S. chemical industry. Fibers are on the leading edge of the chemical business cycle, often tipping off changes for the rest of the industry by several months or longer. The main underpinning in fibers' current improvement, a steep rise in the rate of plant capacity use, would be especially beneficial if it spreads to the rest of the industry. Fiber industry representatives are still cautious on the outlook for their products, three of which—polyester, nylon, and acrylic—are given in detail on the following pages as part of C&EN's new Key Polymer series (C&EN, ...

Acute decompression sickness: 50 cases.

In a review of the most recent 50 consecutive cases of acute decompression sickness in US Navy divers undergoing training at the Naval School, Diving and Salvage, in no instance was recompression following the initial treatment necessary, nor was there any permanent morbidity post-treatment. Factors common to this series are 1) strict physical screening and conditioning; 2) physician and diver awareness of the signs and symptoms of decompression sickness; 3) short surface interval between symptom onset and recompression; 4) aggressive diagnostic and therapeutic use of hyperbaric oxygenation, and 5) judicious use of adjunctive measures such as intravenous fluid and dexamethasone (Decadron). In the ideal management, the physician sees the patient shortly after symptom appears. As soon as central nervous system involvement appears, 100% oxygen by mask is administered and the patient is recompressed supine to 60 feet of sea water.

Studies of Urticaria and Acute Serum Sickness With the C1q Precipitin Test

The C1q precipitin test was performed in serum samples from five groups of patients: (1) 20 patients with acomplementemic systemic lupus erythematosus glomerulonephritis (SLE), (2) 2 patients with serum sickness due to the administration of horse serum, (3) 2 patients with serum sickness preceding hepatitis B, (4) 50 patients with chronic urticaria, and (5) 30 normal controls. Positive C1q precipitin tests were found in all patients with SLE and the four cases of serum sickness. Positive tests correlated with depressed serum complement (C3 and C4) levels and were found only in the early phase of serum sickness. Urticaria patients uniformly had negative C1q precipitin tests and normal serum complement levels.

Experimental studies of neurotoxic activity in blood fractions from acute cases of grass sickness

Plasma, serum and cells were prepared from blood taken from acute cases of grass sickness, and plasma was fractionated by gel filtration and salt precipatation. These preparations were all tested for neurotoxic activity by injection into ponies. Plasma and serum were found to produce the neurohistological changes seen in grass sickness, as was a plasma protein fraction of molecular weight 30,000 or greater. Activity was retained following storage at--75 degrees C for 15 months. Plasma given orally to a pony produced no detectable effect, nor was activity demonstrated following the injection of plasma or the high molecular weight fraction to mice, rats, guinea-pigs or rabbits.

Bone lesions in the femur heads of four autopsy cases of acute decompression sickness

Bone lesions in the femur heads of four autopsy cases of acute decompression sickness

Three Autopsy Cases of Acute Decompression Sickness

Three Autopsy Cases of Acute Decompression Sickness

A case of motion sickness treated by systematic desensitization and in vivo relaxation

A 13-yr-old male was treated for a life-time history of nausea and vomiting which sometimes occured while riding in a car or bus. An in vivo relaxation procedure required the client to hold a deep breath and counterpose his stomach muscles for five seconds upon approaching and sitting in a vehicle. Systematic desensitization was to thoughts of travel by car and bus and to the symptoms of motion sickness. From treatment to 19 months' follow-up, the client has been able to go on many trips by car and bus and remain free of nausea and vomiting.

ACCUMULATIONS OF NOR‐ADRENALINE ASSOCIATED WITH AXONAL CHANGES IN AUTONOMIC GANGLIA IN GRASS SICKNESS

Stellate ganglia from cases of grass sickness and control horses were examined, using the formaldehyde‐induced fluorescence method, for the presence of catecholamines. Accumulations of a catecholamine, identified as nor‐adrenaline, were observed in nerve fibre tracts within ganglia of horses with grass sickness. On the grounds of site and morphology these accumulations conform with axonal lesions seen in silver‐stained sections. The changes were compared with the results of experimental trauma to adrenergic nerves, and it was deduced that there is a primary axonal lesion in grass sickness. It was further suggested that this lesion may be caused by the neurotoxin already implicated in the disease.

CHROMATOLYSIS AND AXONAL DYSTROPHY IN THE AUTONOMIC NERVOUS SYSTEM IN GRASS SICKNESS OF EQUIDAE

Light and electron microscopic examinations of autonomic ganglia from cases of grass sickness have been carried out. The main alterations are pyknosis, cytoplasmic vacuolation originating from granular endoplasmic reticulum, and axonal dystrophy. The cell body changes bear some resemblance to chromatolysis.

Observations on the Coeliaco-Mesenteric Ganglia of Horses with and without Grass Sickness

SUMMARY A histological examination was made of the coeliaco-mesenteric ganglia of 50 horses that were examined post mortem during the period 1966–1971. Seventeen of the animals had the clinical signs and post-mortem appearance of grass sickness and their coeliaco-mesenteric ganglia contained numerous degenerate, foamy and necrotic neurones. Thirty-two of the horses had neither the symptoms nor the macroscopic lesions of grass sickness and their coeliaco-mesenteric ganglia did not contain numerous foamy and necrotic neurones. The remaining animal was diagnosed as a case of grass sickness on clinical and post-mortem findings but it did not have the changes associated with grass sickness in its coeliaco-mesenteric ganglic. These results are discussed.

Observations on Neuronal Changes in Grass Sickness of Horses

This paper deals with 35 cases of grass sickness. In every case, changes were observed in autonomic ganglia, certain brain-stem nuclei and the intermedio-lateral nucleus of the spinal cord. Ganglionic lesions were found to be more extensive and severe in acute and sub-acute cases than in chronic cases. The possible association between the neuronal lesion and the alimentary signs is discussed.

On the pathology of chronic mountain sickness.

In this report we described the findings in a case of Chronic Mountain Sickness, autopsied at Cerro de Pasco (4,300 feet) and compared with the limited pathologic observations reported by others. It is aparent that in fatal cases of Chronic Mountain Sickness the main changes are located at the level of the pulmonary circulation and are of the type that lead to Chronic Cor Pulmonale. So far histologic studies have been reported only in cases of secondary Chronic Mountain Sickness. The basic pathology in Primary Chronic Mountain Sickness or Monge’s disease remain to be defined.